Hellenic Journal of Psychology

Volume 06, 2009

ISSN 1790-1391

Legally responsible

George Grouios
 
President of the Psychological Society of Northern Greece
Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece. Phone: +30-2310-992177; E-mail: ggrouios@phed.auth.gr

Editors

Editor-in-Chief:
Anastasia Efklides Aristotle University of Thessaloniki, Greece

Associate Editors:
Maria Dikaiou, Aristotle University of Thessaloniki, Greece
Angeliki Leondari, University of Thessaly, Volos, Greece
Georgios D. Sideridis,  University of Crete, Rethymno, Greece

Assistant Editors:
Irini Dermitzaki, University of Thessaly, Volos, Greece
Mary H. Kosmidis, Aristotle University of Thessaloniki, Greece
Filippos Vlachos, University of Thessaly, Volos, Greece
Plousia Misailidi, University of Ioannina, Greece
Pagona Roussi, Aristotle University of Thessaloniki, Greece

Guest Editors of the Special Issue:
Evrinomy Avdi, Aristotle University of Thessaloniki, Greece
Mary H. Kosmidis, Aristotle University of Thessaloniki, Greece

Editorial Board

Anastasia Efklides, Aristotle University of Thessaloniki, Greece
George Grouios, Aristotle University of Thessaloniki, Greece
Shulamith Kreitler, Tel-Aviv University, Israel
Diomedes Markoulis, Aristotle University of Thessaloniki, Greece
Robert Neimeyer, University of Memphis, USA
Markku Niemivirta, University of Helsinki, Finland
Jose M. Prieto, Complutense University, Madrid, Spain
Wolfgang Schnotz, University of Koblenz-Landau, Landau, Germany
Yannis Theodorakis, University of Thessaly, Volos, Greece
Maria Tzouriadou, Aristotle University of Thessaloniki, Greece
Marja Vauras, University of Turku, Finland
Marcel Veenman, University of Leiden, The Netherlands

Publisher

ALPHABET S.A., Vrilissou 80, Poligono, 114 76 Athens, Greece. Tel: +30-210-646686

Issue 1

Exploring the mind with a microscope: Freud's beginning in neurobiology

Lazaros C. Triarhou
University of Macedonia, Thessaloniki, Greece

Abstract (Summary):

Sigmund Freud (1856-1939), the acknowledged founder of psychoanalysis, started his research career as a promising neurobiologist. This article presents an overview of his early articles in neuroanatomy and a literature update regarding the awareness of Freud’s origins in neurobiology. In all, Freud invested a decade studying animal histology, cell biology and basic neuroscience before turning to human neuropsychiatric disorders. Through his histological studies, Freud provided coherent evidence supporting the neuron doctrine and suggesting that the protoplasm consists of a contractile fibrillary network, the present-day cytoskeleton. Freud also documented movements of nucleoli in neurons, a phenomenon presently referred to as nuclear rotation. In certain instances, Freud’s observations antedate later views by more than half a century and are important to our understanding of neuronal structure and intracellular motility.

Keywords: Freud, History of neuroscience, Neurohistology, Neuron theory.

Address: Lazaros C. Triarhou, Department of Educational and Social Policy, School of Economic and Social Sciences, University of Macedonia, Egnatia 156, 540 06 Thessaloniki, Greece. E-mail: triarhou@uom.gr

* Published in English.

The contemporary relevance of Freud's work

Themistocles Katrios
North Hellenic Psychoanalytic Society, Thessaloniki

Abstract (Summary):

This selective and brief overview of the importance and contemporary relevance of Freud’s work draws from object relations theory. Aside from setting the foundations of psychoanalysis, Freud’s thinking moved towards various directions which Freud himself was not always able to follow through, although later psychoanalysts used and developed them with significant results. Special mention is made to the gradual shift from a drive-structure model to a relation-structure model of the mind. In addition, emphasis is given to the non-repressed unconscious, that is the area of mental life without representation, an area which contemporary psychoanalysis has begun to explore and which, as an observation, has its origin in Freud’s work.

Keywords: Dream, Non-repressed unconscious, Psychoanalysis.

Address: Themistocles Katrios, North Hellenic Psychoanalytic Society, Agias Sofias 20, 546 22 Thessaloniki, Greece. E-mail: ntiane@otenet.gr

* Published in Greek.

The application of psychoanalytic theory and practice in the general hospital

Ioanna Ierodiakonou-Benou
Aristotle University of Thessaloniki, Greece

Abstract (Summary):

Psychoanalytic theory and technique, closely connected to Freud’s name, is the first great conception through which symptoms can be decoded as the result of intrapsychic conflicts, and their meaning can be seen to reflect the individual’s characterological structure. The work of the founder of psychoanalysis involves clinical and theoretical issues that are still relevant today. The application of Freud’s work to clinical practice concerns not only the wide spectrum of the neuroses, but also the understanding of the psychotic process and personality disorders. In addition, it creates new ways of understanding symptomatology and dynamics, with the possibility of intervention in various mental health settings (e.g., general hospitals, liaison consultation psychiatry, Balint groups)

Keywords: General hospital, National health service, Psychoanalytic psychotherapy.

Address: Ioanna Ierodiakonou-Benou, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece. E-mail: ioannabenou@gmail.com

* Published in Greek.

Post-Freudian encounters between psychoanalysis and culture

Ruth Parkin-Gounelas
Aristotle University of Thessaloniki, Greece

Abstract (Summary):

This paper locates a crucial point of convergence between psychoanalysis and culture in the concepts of the symbol and the sublime. Although they underpin all of Freud’s writing in culture, it was not until the second half of the 20th century that theories of symbolization and sublimation began to be adequately theorized, in particular in the work of Lacan and Castoriadis. Using Lacan’s paradoxical insight that the sublime is precisely that which eludes sublimation, this paper analyzes the play-within-a-play in A midsummer night’s dream focusing on the way Shakespeare foregrounds the chink in the wall as not an obstacle to but a protection of the lovers—from the traumatic encounter with the Real of loss. Similarly, in Defoe’s Robinson Crusoe, it is the threatened loss of the symbol in the form of the mysterious footprint which poses the greatest threat to the human psyche. Finally, the paper examines the Kleinian features of Lacan’s theory of the sublime, and argues that the drive towards symbolic repair, however differently formulated, underlies both their theories of sublimation.

Keywords: Freud, Lacan, Sublimation, Symbolization.

Address: Ruth Parkin-Gounelas, Department of English Language and Literature, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece. E-mail: gounelas@lit.auth.gr

* Published in English.

Diagnosing possible mental health problems in pervasive disorders: A case report

Panagiotis Siaperas & Stephen Higgins
University of Cambridge, UK & Institute of Psychiatry-King’s College London, UK

Abstract (Summary):

The last twenty years services and knowledge about conditions in pervasive developmental disorders have been improved. However, today there are still people with borderline abilities who are either misdiagnosed or undiagnosed and in many cases they receive accurate diagnosis only after referral of symptoms of mental health problems. One of these examples is being presented in the case study of Khaldon. He is a second-generation adolescent immigrant in Britain with Turkish background. Interviews with his mother and with Khaldon reveal that he has an undiagnosed pervasive developmental disorder, specifically Asperger’s syndrome. Despite the limited information about Khaldon, it is notable that he needs support for additional mental health problems. This case study presents Khaldon’s psychological problems, the difficulties he faces because of Asperger’s syndrome, the confusion of mental health professionals in diagnosing Asperger’s syndrome from psychotic disorder and vice-versa and proposes the guidelines of a treatment adapted to Asperger’s syndrome.

Keywords: Asperger’s syndrome, Mental health, Pervasive developmental disorders.

Address: Panagiotis Siaperas, University of Cambridge, Section of Developmental Psychiatry, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK. Email: panagiotis.siaperas@gmail.com

* Published in English.

Prediction of bully and victim status among young male offenders

Stavros P. Kiriakidis
University of Thessaly, Volos, Greece

Abstract (Summary):

The present paper explored the relations of bullying and several familial, educational, legal and institutional characteristics of young offenders kept in custody. The sample was 152 randomly selected male young offenders from the largest young offenders’ institution (YOI) in Scotland, UK. They took part in a structured interview asking several socio-demographic characteristics. The sample of the study reported bullying and victimisation behaviour concistent with some but not all previous studies. This mainly reflects differences in conceptualisation and operationalisation of bullying in offenders’ samples. Victim status was associated with being in special school, having a history of poor school attainment, having poor peer relations at school, expecting an unstable living situation post custody and attempted suicide/self-injury. Bully status was associated with the number of times having been sentenced to custody, the time being in YOI for current stay, the total time spent in YOIs, the age the offenders had been at first time in YOI, being in residential care, and having been seen by psychiatrist/psychologist for treatment in custody. Prediction of victim status was better than prediction of bully membership.

Keywords: Adolescence, Bullying, Suicide attempts.

Address: Stavros Kiriakidis, 29 Kapetanaki Str., Ag. Dimitrios, 173 42 Athens, Greece. Tel./Fax: +30-210-9828455. E-mail: skyriak@syros.aegean.gr & kiriaks@yahoo.gr

* Published in English.

Morphological awareness, spelling, and dyslexia: Classification and evaluation of empirical studies

Styliani N. Tsesmeli
University of Aegean, Rhodes, Greece

Abstract (Summary):

The present literature review is aiming at presenting contemporary research data in relation to the new research area of morphological awareness. Specifically, the review deals with studies regarding (i) the development of morphological awareness in normal and atypical populations in relation to literacy acquisition, and (ii) the use of morphological strategies in the acquisition of spelling by these populations. The research findings are discussed in terms of (a) age and individual differences in orthographic competence, (b) the relationship between morphological awareness and literacy, and (c) the contribution of phonology and other language features in the development of morphological awareness.

Keywords: Developmental dyslexia, Morphological awareness, Spelling.

Address: Styliani Ν. Τsesmeli, Department of Primary Education, University of Aegean, 851 00 Rhodes, Greece. Tel.: +30-22410-99210. Fax: +30-22410-99244. E-mail: stsesmeli@rhodes.aegean.gr

* Published in Greek.

Issue 2

Self-determination theory and physical activity: The dynamics of motivation in development and wellness

Richard M. Ryan, Geoffrey C. Williams,Heather Patrick, & Edward L. Deci
University of Rochester, New York, USA

Abstract (Summary):

To introduce this special issue, we overview self-determination theory (SDT) as it is applied to physical activity, sport, and health. SDT distinguishes intrinsic and extrinsic motivations for physical activities, and specifies separate mini-theories addressing the nature, determinants, and consequences of each. Cognitive evaluation theory (CET) details the central role of intrinsic motivation in both sport and physical activity, and the impact of autonomy and competence supports in promoting people’s intrinsic motivation. Organismic integration theory (OIT) describes different forms of extrinsic motivation that vary in their relative autonomy, affecting both persistence and performance. OIT suggests that more internalized extrinsic goals, being more volitional, are better maintained over time. We also review basic psychological need theory (BPNT), which specifies the role of autonomy, competence, and relatedness satisfaction in facilitating and sustaining motivation, and the impact of intrinsic (e.g., health) and extrinsic (e.g., attractiveness) goals in physical activity. We then outline a SDT perspective on vitality and its depletion, including new research on how contact with nature can enhance subjective energy. We conclude by discussing field research, including controlled clinical trials, testing the efficacy of SDT-based interventions in the promotion of physical activity, and other health-related outcomes.

Keywords: Health, Motivation, Physical activity, Self-determination, Vitality.

Address: Richard M. Ryan, Clinical and Social Psychology, University of Rochester, Box 270266, Rochester, NY 14627-0266, USA. Phone: +1-585-2758708. Email: ryan@psych.rochester.edu

* Published in English.

Affective consequences of imposing the intensity of physical activity: Does the loss of perceived autonomy matter?

Spiridoula Vazou Ekkekakis & Panteleimon Ekkekakis
University of Crete, Rethymno, Greece & Iowa State University, Ames, Iowa, USA

Abstract (Summary):

There is a common belief that, when allowed to select their exercise intensity, most people choose levels too low to accrue substantial benefits. Thus, one of the presumed functions of exercise practitioners is to “push” participants. A previous study showed that, if the imposed intensity exceeds the self-selected by even 10%, this suffices to reduce pleasure. Here, we isolated the effect of autonomy loss by having participants (a) exercise at a self-selected intensity and (b) exercise at an intensity set by the experimenter, which was identical to the self-selected. This reduced perception of autonomy and choice, and also attenuated increases in energy and levels of interest/enjoyment after the controlled condition. These effects could not be accounted for by differences in intensity, perceived competence, or self-efficacy. Thus, consistent with self-determination theory, loss of perceived autonomy in setting one’s level of exercise intensity can negatively impact affect, with potentially negative implications for adherence.

Keywords: Affective valence, Arousal, Exercise prescription, Perceived exertion.

Address: Spiridoula Vazou-Ekkekakis, Department of Primary Education, School of Education, University of Crete, Gallos Campus, 741 00 Rethymno, Greece. E-mail: svazou@edc.uoc.gr

* Published in English.

Subjective psychological distress among young adults: The role of global and contextual levels of self-determined motivation

Étienne Julien, Frédéric Guay, Caroline Senécal, & Sarah-Caroline Poitras
Laval University, Québec, Canada

Abstract (Summary):

The purpose of this study was to contrast two perspectives on the linkages between levels of self-determined motivation and subjective psychological distress. The first perspective posits that global self-determined motivation (i.e., a trait) is more negatively related to psychological distress than contextual self-determined motivations in leisure, interpersonal relationships, and education. The second perspective, in contrast, posits that self-determined motivation in these three contexts are more negatively related to subjective psychological distress than global self-determined motivation. Participants were 1039 college students who collaborate to a five-year prospective study. Results from structural equation modeling provided more support for the second perspective than for the first one. Discussion centers on the theoretical and practical implications of the results.

Keywords: Contextual levels of motivation, Global levels of motivation, Self-determination, Subjective psychological distress.

Address: Frédéric Guay, Chairholder of the Canada Research Chair on Motivation and Academic Success, Department of Basic and Applied Education, Faculty of Educational Sciences, Laval University, Quebec, G1K 7P4 Canada. Phone: +1-418-6562131 Ext. 2379. Fax: +1-418-6562885. E-mail: Frederic.Guay@fse.ulaval.ca

* Published in English.

The role of perceived psychological need satisfaction in exercise-related affect

Philip M. Wilson*, Diane E. Mack*, Chris M. Blanchard**, & Casey E. Gray*
Vol. 6 (2009) pp. 183-206
*Brock University, St. Catharines, Ontario, Canada, & **Dalhousie University

Abstract (Summary):

The aim of this investigation was to examine the role of psychological need fulfillment in promoting affective responses to exercise from the perspective of self-determination theory. Participants in the two studies (N ranged from 140 to 175) were university students and staff who completed measures of psychological need satisfaction and exercise-related affect. Descriptive statistics across both studies indicated that participants reported greater satisfaction of competence and autonomy than relatedness needs in exercise although minimal differences were evident in Study 2. Structural equation modeling analyses conducted in Study 1 supported the contribution of a latent variable representing overall psychological need satisfaction to positive well-being and psychological distress. Multiple regression analyses conducted in Study 2 supported the link between greater satisfaction of SDT-based needs with enhanced positive and reduced negative affect in exercise settings and provided no support for the influence of gender on the perceived psychological need satisfaction-exercise affect relationship.

Keywords: Internalization, Self-determination theory, Well-being.

Address: Philip M. Wilson, Department of Physical Education & Kinesiology, 500 Glenridge Avenue, Brock University, St. Catharines, Ontario, L2S 3A1 Canada. Phone: +1-905-6885550 Ext. 4997, Fax: (905) 688-8364. E-mail: phwilson@brocku.ca

* Published in English.

Psychological needs and subjective vitality in exercise: A cross-gender situational test of the needs universality hypothesis

Symeon P. Vlachopoulos & Eleni Karavani
Aristotle University of Thessaloniki, Greece

Abstract (Summary):

The present study examined (a) the mediating role of the psychological needs for autonomy, competence, and relatedness in the relationship between perceived autonomy support and levels of subjective vitality among Greek-speaking exercise participants at the situational level of generality; and (b) the validity of the needs universality hypothesis across gender in exercise. Exercise participants (N = 388) aged between 18 and 61 years completed scales assessing situational exercise-instructor perceived autonomy support, psychological need satisfaction, and levels of subjective vitality at the end of a single exercise class. Multi-sample latent variable structural equation modeling supported both partial mediation of the psychological needs in the relationship between perceived autonomy support and subjective vitality and the equivalence of the effects of the psychological needs for autonomy, competence, and relatedness on subjective vitality across gender providing support for the needs universality hypothesis. The findings open new research avenues to test the relative effectiveness of various exercise instructing styles on improving indexes of psychological health and well-being and the equivalence of the psychological processes involved across gender.

Keywords: Multi-group analysis; Physical activity; Psychological well-being, Self-determination theory.

Address: Symeon P. Vlachopoulos, Laboratory of Social Research on Physical Activity, Department of Physical Education and Sport Science at Serres, Aghios Ioannis, 621 10 Serres, Greece. Phone: +30-2310-991045. E-mail: vlachop@phed-sr.auth.gr

* Published in English.

Comparing self-determination and body image between excessive and healthy exercisers

Michelle S. Fortier & Robin J. Farrell
School of Human Kinetics, University of Ottawa, Ontario, Canada & Victoria, British Columbia, Canada

Abstract (Summary):

The influence of self-determination and body image on exercise behavior was examined using a multi-method approach. A series of validated scales was administered to 218 male and female exercisers to compare the exercise motivation and perceived body image of four groups exhibiting low to high levels of both exercise behavior and commitment. Exercisers identified as having the most “excessive” exercise behaviors (N = 4) were also interviewed. Analyses of quantitative data revealed that “excessive” exercisers displayed higher levels of introjected regulation and of self-determined forms of motivation than “healthy” exercisers. Qualitative findings revealed health/fitness and appearance-related motives, and guilt as a motivating factor for “excessive” exercisers. Quantitative results are discussed according to self-determination theory and past research. Interview findings suggest body image does influence excessive exercise behavior.

Keywords: Exercise, Motivation, Multi-method, Self-determination theory.

Address: Michelle Fortier, School of Human Kinetics, Montpetit Hall, 125 University, University of Ottawa, Ontario K1N 6N5, Canada. Tel: +1-613-5625800 (4275); Fax: +1-613-5625149. E-mail: mfortier@uottawa.ca

* Published in English.

The mediating role of behavioural regulations in the relationship between perceived body of discrepancies and physical activity among adult women

David Markland
Bangor University, UK

Abstract (Summary):

Research has shown a negative relationship between perceived body size discrepancies and exercise participation among women. This might be explained from a self-determination theory perspective by perceived discrepancies between actual and ideal body size causing individuals to feel less autonomous in the regulation of their exercise behaviour. The aim of this study was to test the mediating role of exercise behavioural regulations in the relationship between body size discrepancies and physical activity participation. Participants were 102 women who completed measures of body size discrepancies, behavioural regulations and physical activity. Analyses showed that a reduction in more autonomous regulations mediated a negative relationship between discrepancies and physical activity. Less autonomous regulations did not play a mediating role. Thus it appears that body size discrepancies exert a negative influence on physical activity by decreasing feelings that exercise is a valued and enjoyable activity rather than by leading people to feel more externally or internally controlled in their behaviour.

Keywords: Body image, Exercise, Self-determination.

Address: David Markland, School of Sport, Health & Exercise Sciences, Bangor University, George Building, Holyhead Road, Bangor, Gwynedd, LL57 2PZ, UK. Fax: +44-1248-371053. E-mail: d.a.markland@bangor.ac.uk

* Published in English.

Issue 3

Values in acceptance and commitment therapy: A comparison with four other approaches

James E. Yadavaia & Steven C. Hayes
University of Nevada, Reno, USA

Abstract (Summary):

Personal values represent an integral component in Acceptance and Commitment Therapy (ACT), an acceptance-based modern behavioral psychotherapy. Many other psychological approaches have held values to be central to living life. This paper compares and contrasts ACT’s approach to values with four other approaches: client-centered therapy, Motivational Interviewing, positive psychology, and radical behaviorism. The ACT model is described as well as the role of values within that model, and brief clinical examples are provided to illustrate how the ACT approach to values may be used in practice.

Keywords: Behavior analysis, Motivational Interviewing, Positive psychology, Values.

Address: James Yadavaia, Department of Psychology, University of Nevada, Reno, NV 89557-0062, USA. E-mail: yadavaia@unr.nevada.edu

* Published in English.

The nature and basis for compassion focused therapy

Paul Gilbert
Mental Health Research Unit, Kingsway Hospital, De

Abstract (Summary):

People with complex emotional difficulties sometimes find it difficult to emotionally engage with psychological therapy. They may say things such as, “I understand the logic of the therapy, and it makes perfect sense but I just can’t feel it”. These kinds of difficulties are often underpinned by shame and self-criticism. Such individuals often come from harsh or neglectful backgrounds and have experienced low affection. Compassion focused therapy suggests that: (a) Shame and self-criticism are forms of safety strategies that can be resistant to change. (b) The ability to feel reassured by the therapist and therapeutic interventions depends upon activation of a specialised emotion system that gives rise to the feelings of safeness, soothing and reassurance. (c) For some people this system is inaccessible and/or frightening to work with. (d) Increased access and activation of the soothing, safeness and reassurance system can be a key focus of therapy.

Keywords: Compassion, Self-criticism, Shame.

Address: Paul Gilbert, Mental Health Research Unit, Kingsway Hospital, Derby, UK. E-mail: p.gilbert@derby.ac.uk

* Published in English.

Affect regulation, metacommunication and mindfulness in action

Jeremy D. Safran & Julia N. Belotserkovsky
New School for Social Research, New York, USA

Abstract (Summary):

Deficits in affect regulation skills play an important role in many forms of psychopathology. Affect regulation involves tolerating, moderating and making constructive use of a range of affective states, including those that are intensely painful or pleasurable, without needing to dissociate them. In this article, we discuss the role that the therapist’s ability to regulate his or her own affective experience can play in helping patients to regulate their own affective experience. The therapeutic encounter involves an on ongoing process of mutual affective regulation between therapist and patients through which both partners influence each other’s affective experience. Patients with affect regulation problems are likely to evoke intense feelings in their therapist, and the therapist’s ability to work constructively with their own internal experience is an important therapeutic skill. We explore the role that both mindfulness practice and therapeutic metacommunication (i.e., the process of collaboratively exploring what is taking place between therapist and patient in a reflective and nonjudgmental fashion) can play in facilitating the process of affect regulation in both therapist and patient.

Keywords: Affect regulation, Metacommunication, Mindfulness, Psychopathology.

Address: Jeremy D. Safran, Psychology Department, New School for Social Research, 80 Fifth Ave., New York, NY 10011, USA. E-mail: safranj@newschool.edu

* Published in English.

Some implications of attachment research for psychotherapeutic practice

Jeremy Holmes
University of Exeter, UK

Abstract (Summary):

The implications of current findings in attachment theory for psychoanalytic practice are reviewed. Discussion is divided into three sections: the therapeutic relationship; meaning making; promoting change. It is argued that attachment provides a “meta-perspective” from which the interactions of therapist and client can be viewed. Key themes discussed include: Goal Corrected Empathic Attunement as a stimulator of vitality affects and companionable exploration in therapy; the emergence of narrative competence and meaning in the context of secure attachment to the therapist; the paradoxical nature of therapy as a “positive double bind” aiming to stimulate psychic development and reorganisation. The tripartite rubric is applied to the difficulties of working with borderline clients and how these may be overcome.

Keywords: Attachment, Psychoanalysis, Psychotherapy.

Address: Jeremy Holmes, Department of Psychology, University of Exeter, Exeter EX4 4 QG, UK. E-mail: j.a.holmes@btinternet.com

* Published in English.

Seeking a balance between knowing and not knowing in the consulting room

Patrick Casement
Fellow of the Institute of Psychoanalysis, London

Abstract (Summary):

Psychoanalysis has been based upon a theory that suggests that those properly trained become able to know some of what is in the unconscious minds of their patients, which the patients themselves cannot know. But the power differential in this can lead to problems. It is all too easy for the link between theory and interpretation to become circular and self-proving. I therefore maintain that it is sometimes important to stay with not knowing for longer than in some analyses, in order to remain open to meanings that could be more relevant to the individual patient, rather than treating similar patients as if they were more nearly the same. It then becomes important that we also learn to differentiate between those times when not knowing is appropriate from others when it is a firmer sense of knowing that is necessary. I try to indicate something of the balance between knowing and not knowing that I believe to be a skill that all analysts need to develop.

Keywords: Certainty, Non-certainty, Psychoanalysis.

Address: Patrick Casement, 122 Mansfield Road, London NW3 2JB, UK. E-mail: patrick@pcasement.fsnet.co.uk

* Published in English.